Physical Exam One

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Physical Exam One
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2012-03-07 20:14:19
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Physical exam one
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Bates physical exam one test.
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  1. What are some common types of assessment?
    • Comprehensive
    • Focused
    • Problem-oriented
    • Routine clinical checkup
    • Periodic physical exam
    • Subjective vs objective data
  2. What type of assessment assesses symptoms restricted to a specific body system
    Focused
  3. What assessment takes alot of time.
    Comprehesive
  4. What are the seven components of a Comprehensive adult history
    • Identifying- Data and source of history
    • Cheif Complaint
    • Present illness
    • Past History
    • Familty History
    • Personal or Social Hx
    • Review of systems
  5. Reliability
    Varies on pts memory trust and mood
  6. Present illness (HOPI) does what an includes what
    Amplifies C/C, describes development of symptoms, includes PTs thoughts about the illness and feelings.
  7. What is tangential Lighting?
    Lighting from an angle
  8. What is perpendicular lighting
    Straight down son!
  9. Pediactric exams should allow for what type of otoscopy
    Pneumatic Ostoscopy
  10. Thick walled tubing should be _____cm to ____cm long.
    30-38cm or 12-15in
  11. What is used for two point discrimination?
    Safety pin, Q-tips
  12. Tuning forks should be between how many Hz?
    128hz to 512 hz
  13. Draping a patient is to...
    visualize one area of the body at a time and preserve modesty
  14. What inspection techniques should be used?
    • Inspection
    • Palpation
    • Percussion
    • Auscultation
  15. What is a bruit?
    Turbulence over arterial vessels
  16. Whysical exam principles
    • Develop a systematic sequence of examination
    • Maximize patients comfort
    • Avoid unnecessary changes in position
    • Enhance clinical efficiency
  17. What do you check for in the heart
    S3 and murmer of mitral stenosis
  18. Quality of an Xray is based on...
    • Skill of the xray taker
    • Proper interpretation
  19. What is needed in order to take an xray
    • A source to produce the xrays
    • A method to record
    • A way to process the recorded image
  20. What population are Xrays dangerous to?
    Pregos
  21. What uses a rotating xray beam and multiple rotating detectors?
    Computed tomagraphy
  22. Data is collected from a CT scan producing multiple...
    slices of 2D images
  23. CT can be completed within ___ min
    five
  24. CT scans are best for...
    Neuroimaging, abdominal and pelvic studies, soft tissues and checking for fractured organs
  25. Ultrasound can see what
    Images in real time and blood flowing through blood vessels
  26. What is the equipment held to the skin that sets off high frequency sound waves?
    transducer
  27. The image of an ultrasound is based on what?
    Frequency, strength (amplitude) of sound signal and the time it takes to return from the patient to the transducer
  28. The area between the liver and the kidney is.
    Morrisons pouch.
  29. U/S has difficulty penetrating through...
    Bone, gas filled structures
  30. What is used to listen to the fetal heartbeat (U/S)?
    Dopplar fetal heart rate monitor
  31. Equipment needed for U/S
    • Ultrasound machine
    • Appropriate transducer
    • Ultrasound Gel
  32. MRI uses what to obtain images?
    Strong magnetic fields and radio waves.
  33. MRI is best for
    soft tissue, tumor detection, spinal cord injuries, non iodine contrast agents
  34. Scans with the MRI take how long?
    20-45 minutes
  35. MRI is _______________ in pregnant patients for ...
    Contraindicated, some providers
  36. CT and MRI are generally displayed in three planes or slices, they are
    • Sagittal
    • Coronal
    • Axial (horizontal) or transverse
  37. Denser objects will have a _________ appearance on an Xray because it absorbs more xrays
    whiter
  38. Air appears as what color on an xray?
    Black
  39. Fat shows up as ______ on an xray
    dark grey
  40. These two have the same density on an Xray.
    Fluids and soft tissue
  41. Tissue contrast is determined on an MRI by...
    How quickly the nuclei recover from radiowave stimulation
  42. Five technicat factors to evaluate on a chest xray
    • Penetration
    • Inspiration
    • Rotation
    • Magnification
    • Angulation
  43. During a CXR, you should be able to barely see the _______ through the heart
    thoracic spine
  44. To check for proper inspiration in a CXR, how many ribs posterior ribs should be visible in a

    Normal PT

    Hospitalized PT
    10

    9
  45. Another way to determine a proper CXR is
    5,6,7 anterior rib intersecting with the diaphragm at the MCL
  46. When an xray beam is angled towards the head, the film obtained is an _________
    apical lordotic view
  47. For a lordotic view, the clavicle must be over the _____ rib
    Third
  48. Two incomplete fractures are
    greenstick, tarus
  49. Angle of a fractures is the relation of the ________ to the proximal
    distal
  50. Shortening is measured in ____ when there is overlap
    centimeters
  51. Xrays are
    high frequency, electromagnetic ionizing rays
  52. Inverse square law is
    Double the distance decreases the effects by quadruple
  53. Steps in clinical reasoning are
    • ID abnormal findings
    • Localize the findings anatomically
    • Interpret and find probably process
    • Make a hypothesis
  54. Steps in finding a hypothesis are
    • Select most specific and critical findings
    • Math findings against any conditions that could produce em
    • Eliminate diagnostic possibilities that fail to explain findings
    • Weigh competing posibilities
    • Give special attn to life threatening and treatable conditions
    • Test hypothesis
    • Develop working diagnosis
    • Develop a plan
  55. Statistical tools are
    • Reliability
    • Validity
    • Sensitivity
    • Specificity
    • Predictive value
  56. Sensitivity in statistical data
    ID the person who will test positive in a group of people who have the disease.

    Good at picking up disease
  57. Specificity
    ID people who test negative in a group without the disease
  58. Predictive value
    Indicates how well a given symptom or test will predict the prescense or abscense of a disease
  59. How do you respond to emotional cues with a PT?
    • Naming
    • Understanding
    • Respect
  60. An interpreter should be seated...
    next to the patient
  61. CAGE for alcoholism is...
    • Need to CUT DOWN
    • Other people get ANNOYED
    • Feelings of GUILT
    • Eyeopener
  62. Three dimensions for cultural awareness
    • Self-awareness
    • Respectful Communication
    • Collaborative Partnerships
  63. Building blocks of professional ethics are
    • Nonmalificence
    • Beneficence
    • Autonomy
    • Confidentiality
  64. The Tavistock principles
    • Rights
    • Balance
    • Comprehensiveness
    • Cooperation
    • Improvement
    • Safety
    • Openness
  65. Vitals needed (basic)
    • Temperature
    • Blood Pressure
    • Heart Rate
    • Respirations
  66. The width of a BP cuff should be ____ of the length of the upper arm.
    40%
  67. The length of a BP cuff should be _____ of the arm _______
    80% of the arm circumference
  68. When taking BP use PT's _______ arm first
    non dominant
  69. Caffiene and nicotine should be avoided for ____ min before a BP check
    30 min
  70. Inflate the cuff until the pulse disappears then add ____ mm Hg to the cuff
    30 mm Hg
  71. Listen for a BP with the stethoscope over the _____
    Brachial artery
  72. If readings after measuring both arms are over 10 mm Hg then __________, if still different PT might have a _______
    • repeat measurement,
    • aortic dissection
  73. White coat hypertension occurs in _____
    You should _____
    • 10-25% of pts
    • Relax the PT and tried again later in the visit
  74. Assess heart rate for____
    One full minute
  75. Any irregular heart rate rythms should be verified with a...
    electrocardiogram
  76. Hyperpyrexia is an ______ temperature
    106 degrees DAMN!
  77. A recurring shaking chill suggests an....
    extreme rise in temp and possible systemic bacteria/virus
  78. Feeling hot and sweaty accompanies
    A falling temperature
  79. Chronic pain lasts over ______
    One month
  80. Idiopathic pain is
    Pain with unknown cause
  81. The four As of pain management are
    • Analgesia
    • Activities of daily living
    • Adverse effects
    • Abberant drug related behaviors
  82. A good BMI is between....
    18.5-24.9
  83. Patients over the age of 50 should be advised to take more...
    • calcium
    • Vitamin B12
  84. Mobility in the skin is...
    the easy with which a fold of skin moves
  85. Turgor in skin is...
    the resistance of the skin to deformity
  86. Intertrigo is
    Skin chafin in or under folds of skin
  87. Coalesce means
    to fuse, grow or run together
  88. Vellus hair is
    short, fine, inconspicous and inpigmented hair
  89. The smile line, or cheek line is the...
    nasolabial fold
  90. Functio laesa is
    loss or disturbance of function
  91. Basal cell carcinoma affects how much of the population?
    and begins where?
    • 80%
    • Germinativum
  92. Squamous cell carcinoma affects how much of the population? and occurs where?
    • 16% of population
    • occurs in upper layers of epidermis
  93. Malignant melanoma affects how much of population? Occurs where?
    • 4% affects with 80% of related deaths
    • Melanocytes
  94. The HARMM Model is
    • History of melanoma
    • Age over 50
    • Regular dermatologist absent
    • Male
    • Mole change
  95. A patch that is .5 to 1.5 cm that is uniformly pigmented is a _______ and over _____ with a diameter of 1.5cm can suggest ________
    • cafe au-lait spot,
    • 6
    • Neurofibromatosis
  96. Erethimia on the cheeks of a child can be caused by
    Fifth disease
  97. Psoriases is usually on the _____ surface
    Extensor
  98. A herald lesion that spreads to the trunk and beyond may be
    Pityriasis Rosea
  99. What is a burrow
    a tunnel in the epidermis (5-15 mm), ends at vesicle
  100. Lichenification is
    thickening of epidermis, roughening of skin
  101. Mees lines in nails indicate?
    Arsenic poisoning, leprosy, hodgekins disease
  102. Terrys nails occur when
    Liver disease, CHF, diabetes

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